Difference between revisions of "Reactive changes"

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'''Reactive changes''' is a commonly used term that implies:
'''Reactive changes''' is a commonly used term in [[pathology]] that implies:
# Inflammation.
# Inflammation.
# Nuclear changes compatible with inflammation.
# Nuclear changes compatible with inflammation.
# The absence of both neoplasia ''and'' the suspicion of neoplasia, i.e. it implies benignancy.


''Reactive inflammatory changes'' and ''inflammatory changes'' redirect here.
'''Reactive inflammatory changes''' and '''inflammatory changes''' can be considered synonyms.


==General==
==General==
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*Inflammatory processes.
*Inflammatory processes.
*Repair.
*Repair.
*Neoplastic processes.   
*Neoplastic processes, i.e. pre-cancerous conditions (e.g. dysplasia) and [[cancer]].   


Significance of nuclear changes in inflammation:
Significance of nuclear changes in inflammation:
*The line between a reactive process and a neoplastic process may be fuzzy.  
*The line between a reactive process and a neoplastic process may be fuzzy, i.e. it may be very difficult to be certain whether something is benign or [[malignant]].  


Consequence:
Consequence:
*In the context of inflammation, nuclear changes are typically present and the threshold for calling suspicious or malignancy is typically higher.
*In the context of inflammation, nuclear changes are typically present and the threshold for calling ''suspicious for malignancy'' or ''[[malignancy]]'' is typically higher.


==Microscopic==
==Microscopic==
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**Nuclear enlargement.
**Nuclear enlargement.
**Nuclear hyperchromasia.
**Nuclear hyperchromasia.
**Prominent nucleoli.
**Prominent [[nucleoli]].
*Inflammation - any type (e.g. [[neutrophil|neutrophilic]], [[plasma cells|plasmacytic]], lymphoplasmacytic).
*Inflammation - any type (e.g. [[neutrophil|neutrophilic]], [[plasma cells|plasmacytic]], lymphoplasmacytic).
*+/-Proliferation (e.g. mitotic figures) or changes suggestive of proliferation (e.g. hyperplasia).
Notes:
*Cytoplasmic changes may be present.


DDx:
DDx:
*[[Waffle diagnosis]] (e.g. [[indefinite for dysplasia]]) - nuclear changes of unknown significance.
*Normal.
**Terminology dependent on the anatomical site.  
*[[Waffle diagnosis]] - nuclear changes of unknown significance.
**Terminology dependent on the anatomical site, e.g. [[indefinite for dysplasia]], [[ASCUS]], [[ASAP]].  
*[[Nuclear atypia]].
*[[Nuclear atypia]].
**This is often qualified as it may represent neoplastic process or a benign process dependent on the context.
**This is often qualified as it may represent a neoplastic process or a benign process.
**Common qualifiers:
**Common qualifiers:
***Worrisome lesions: "cannot exclude dysplasia", "suspicious for malignancy".
***Worrisome lesions: "... cannot exclude dysplasia", "... cannot exclude malignancy", "... suspicious for malignancy".  
***Suspected to be benign: "favour benign".
***Suspected to be benign: "... favour benign".
*[[Malignancy]].
*[[Malignancy]].


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*[[NC ratio]].
*[[NC ratio]].
*[[Reactive squamous epithelium of the uterine cervix]].
*[[Reactive squamous epithelium of the uterine cervix]].
*[[Reactive astrocytes]].


[[Category:Stuff]]
[[Category:Stuff]]

Latest revision as of 18:28, 31 July 2016

Reactive changes is a commonly used term in pathology that implies:

  1. Inflammation.
  2. Nuclear changes compatible with inflammation.
  3. The absence of both neoplasia and the suspicion of neoplasia, i.e. it implies benignancy.

Reactive inflammatory changes and inflammatory changes can be considered synonyms.

General

Nuclear changes are seen in:

  • Inflammatory processes.
  • Repair.
  • Neoplastic processes, i.e. pre-cancerous conditions (e.g. dysplasia) and cancer.

Significance of nuclear changes in inflammation:

  • The line between a reactive process and a neoplastic process may be fuzzy, i.e. it may be very difficult to be certain whether something is benign or malignant.

Consequence:

  • In the context of inflammation, nuclear changes are typically present and the threshold for calling suspicious for malignancy or malignancy is typically higher.

Microscopic

Features - generic:

  • Nuclear changes - typically:
    • Nuclear enlargement.
    • Nuclear hyperchromasia.
    • Prominent nucleoli.
  • Inflammation - any type (e.g. neutrophilic, plasmacytic, lymphoplasmacytic).
  • +/-Proliferation (e.g. mitotic figures) or changes suggestive of proliferation (e.g. hyperplasia).

Notes:

  • Cytoplasmic changes may be present.

DDx:

  • Normal.
  • Waffle diagnosis - nuclear changes of unknown significance.
  • Nuclear atypia.
    • This is often qualified as it may represent a neoplastic process or a benign process.
    • Common qualifiers:
      • Worrisome lesions: "... cannot exclude dysplasia", "... cannot exclude malignancy", "... suspicious for malignancy".
      • Suspected to be benign: "... favour benign".
  • Malignancy.

See also